Treatment-resistant depression and innovative therapies
Treatment-resistant depression (or drug-resistant depression) is a form of depression that does not respond adequately to at least two antidepressant treatments carried out correctly in terms of dosage and duration. It affects a significant proportion of patients and calls for new-generation therapeutic approaches.
Prof. Giovanni Martinotti works on treatment-resistant depression in both clinical practice and research, with a particular focus on innovative therapies: esketamine and brain stimulation techniques.
Prof. Martinotti’s research
My work on treatment-resistant depression combines clinical practice and research: we study the effectiveness and safety of the most recent treatments in real-world conditions, to offer a response to patients who do not benefit from conventional therapies…
Prof. Martinotti coordinated the Italian multicentric study REAL-ESK on the use of esketamine in treatment-resistant depression, one of the largest Italian real-world experiences in this area.
Esketamina
Esketamine is a medication (nasal spray) approved for treatment-resistant depression, administered exclusively in a clinical setting under medical supervision. It works through a different mechanism from conventional antidepressants and with a faster onset of action. Prof. Martinotti’s research has documented its effectiveness and safety in real-world clinical practice (REAL-ESK study).
Brain stimulation (TMS)
Transcranial magnetic stimulation (TMS) is a non-invasive technique that modulates the activity of specific brain areas involved in depression. It is performed on an outpatient basis, is generally well tolerated, and represents an option for patients who do not respond to medication.
Frequently asked questions
Q. When is depression considered “resistant”?
A. Depression is considered resistant when symptoms do not improve adequately after at least two different antidepressant treatments, taken at the correct dosage and for the correct duration.
Q. How does esketamine work?
It is a nasal spray administered in a clinical setting under medical supervision. It acts through a different mechanism from conventional antidepressants, targeting the glutamate system, and can work more rapidly. It is not a treatment to be used on one’s own.
Q. Is transcranial magnetic stimulation painful?
A. No. It is a non-invasive and generally well-tolerated procedure, performed on an outpatient basis without the need for anesthesia.
Q. Can treatment-resistant depression be treated?
A. The lack of response to initial treatments does not mean there are no options: it is precisely for these cases that innovative therapies such as esketamine and brain stimulation have been developed, expanding the possibilities of treatment.
D. Altra domanda
Related publications
- Real-world experience of esketamine use to manage treatment-resistant depression (REAL-ESK study) — J. Affective Disorders, 2022 → DOI 10.1016/j.jad.2022.09.043
- Treating bipolar depression with esketamine — Bipolar Disorders, 2023 → DOI 10.1111/bdi.13296
- un lavoro su TMS/stimolazione cerebrale, se si vuole rappresentare anche quel filone
Related media
- Odeon – Eccellenze Italiane: servizio sul disturbo depressivo resistente
- eventuali interviste RAI sul tema
Other research areas: Psychedelics in Psychiatry · Addictions and New Psychoactive Substances